My brother has been HIV positive for about 7 yrs. He has lymphoma, CMV, and his organs are failing. He was recently hospitalized for pneumia (not PCP). He is also anemic, so they put him on erythropoietin. He then developed systemic swelling from the waist down for three weeks. His wife has all but given up, and they have brought Hospice in to care for him. I still think there is something else that they could do for him, besides waiting for him to die!!!they won't ask the doctors. What would cause the systemic shutdown??? Please help in NC

Response from Dr. Dezube

Dear concerned brother:
The most important question I have is what does your brother want. It's hard for me to assess whether or not anything more can be done for him in terms of active treatment (Is his lymphoma new? has it recurred after chemotherapy? What's his CD4 count and viral load? What the status of his CMV?). If indeed he has recurrent lymphoma resistant to chemotherapy, a very low CD4 count, and a high viral load, then supportive care (comfort measures) may be a resonable option. Please realize that if this is his wish, then my best advice to you would be to respect his wishes. Please also realize that if your brother wishes for comfort measures, then indeed something is being done. It's important to understand that your brother is not being abandoned by his caretakers; he may just be switching the focus of his care. You sound like a very concerned brother. Your brother's wishes should be what guides the situation. Good luck. BD.

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